Dental device for positioning the mandible and the maxilla in centric relation and methods for using same

ABSTRACT

A dental device for insertion in a patient&#39;s mouth generally between the patient&#39;s upper and lower teeth for cooperating and positioning the mandible and the maxilla in centric relation. The dental device includes a centric bite assembly including a bite portion which is insertable between the patient&#39;s upper and lower anterior teeth and an impression support assembly connected to and extending a predetermined perpendicular distance away from the centric bite assembly. The dental device also may be used for relieving muscle trismus and pain caused by muscles and diagnosing temporal mandibular joint problems by having the patient bite down on the bite portion tending to position the mandibular and the maxilla in centric relation.

CROSS-REFERENCE TO RELATED APPLICATIONS

Not applicable.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not applicable.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates generally to dental devices and, moreparticularly, but not by way of limitation, to a dental device forpositioning the mandible and the maxilla in centric relation and methodsfor using same.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING

FIG. 1 is a top plan view of a dental device constructed in accordancewith the present invention.

FIG. 2 is a cross-sectional view taken substantially along the lines2--2 of FIG. 1.

FIG. 3 is an exploded view showing the dental device of FIGS. 1 and 2with impression materials aligned for positioning on the dental device.

FIG. 4 is a perspective view showing the impression materials of FIG. 3attached to the dental device of FIGS. 1 and 2 and comprising a portionthereof.

FIG. 5 is a diagrammatic, schematic view showing a portion of a maxillaand a portion of a mandible with the dental device of FIGS. 1 and 2inserted between the upper and the lower teeth with the upper and thelower teeth shown in a partially opened positioned, the mandible and themaxilla not being in centric relation.

FIG. 6 is a view similar to FIG. 5, but showing the upper and the lowerteeth in the closed position with the dental device of FIGS. 1 and 2disposed therebetween, and the mandible and the maxilla in centricrelation.

FIG. 7 is a view similar to FIGS. 5 and 6, but showing the dental deviceof FIGS. 3 and 4 disposed between the upper and the lower teeth withimpression materials connected to the dental device and with theocclusal surfaces of the upper and lower posterior teeth engaging andimpressing upon the impression materials, the mandible and the maxillabeing in centric relation.

FIG. 8 is a schematic, diagrammatic view showing a portion of a typicalarticulator with a maxillary stone model mounted on the articulator withthe dental device along with the impression material disposed on theocclusal surface of the maxillary stone model and showing the mandibularcast disposed on the impression materials and positioned thereon toposition the maxilla and the mandible in centric relation, themandibular cast being shown, prior to connecting the mandibular cast tothe articulator.

DETAILED DESCRIPTION OF THE INVENTION

Referring to the drawings in general and to FIGS. 1 and 2 in particularshown therein and designated by the general reference numeral 10 is adental device constructed in accordance with the present invention. Inone embodiment, the dental device 10 comprises a first and a secondimpression material 12 and 14 (shown in FIGS. 3 and 4).

The dental device 10 is constructed of materials, adapted, sized andshaped to be inserted into a patient's mouth generally between thepatient's upper teeth and lower teeth for cooperating in positioning themandible and the maxilla of the patient in centric relation. The term"centric relation" as used herein means the relationship of the mandibleto the maxilla when the properly aligned condyle-disk assemblies are inthe most superior position against the eminentia, irrespective of toothposition or vertical dimension. In this position, the head of thecondyle of the mandible is in the upper most superior position in theglenoid fossa with a disk assembly between it and the eminentia. Theterm "centric relation" is well known to those skilled in the art ofdentistry, and a more detailed description or illustrations are notdeemed necessary.

An individual patient has two sets of muscles that control centricrelation, a set of elevator muscles and a set of positioner muscle. Theelevator muscles are the masseter, temporalis, medial, pterygoid and thepositioner muscles are the lateral pterygoid, and anterior fibers of thetemporalis. When one set of muscles fires, the other set of musclesshould release. That is, when the elevator muscles fire, the positionermuscles release, and when the positioner muscles fire, the elevatormuscles release. When this does not occur, then there is anin-coordination of the muscles of the masticatory system which can causepain and destruction of the dentition.

The dental device 10 is constructed of materials, adapted, sized andshaped to program the upper and the lower arches back to their originalposition and not to the displaced position. That is, the dental device10 is adapted to cooperate in positioning the mandible and the maxillain centric relation.

Referring to FIGS. 1 and 2, the dental device 10 comprises a centricbite assembly 16 which is constructed of materials, shaped and sized forpositioning in a patient's mouth generally between the upper and thelower anterior teeth while leaving the posterior teeth spaced a distanceapart when the patient bites down on the centric bite assembly 16 withthe anterior teeth engaging the centric bite assembly. At least portionsof the centric bite assembly 16 are constructed of pliable materialadapted to permit the lower anterior teeth to move relative to the upperanterior teeth when the patient bites down on the centric bite assembly16 for cooperating in positioning the mandible and the maxilla incentric relation, as will be described in greater detail below.

The centric bite assembly 16 includes a bite portion 18 which isadapted, constructed of materials, sized and shaped so the patient canbite down on the bite portion 18 when the centric bite assembly 16 ispositioned between the upper and the lower anterior teeth of thepatient. The bite portion 18 in particular is constructed of pliablematerial so that when the patient bites down on the bite portion 18 withat least some of the patient's anterior teeth, the patient's posteriorteeth are spaced a distance apart. In one preferred embodiment as shownin the drawings, the bite portion 18 comprises an arch shaped case 20having a cavity 22 (FIG. 2) formed therein. The cavity 22 is filled witha cavity fill pliable material 24 (FIG. 2).

As shown in FIG. 1, the bite portion 18 has a first end 26 and a secondend 28. The bite portion 18 is shaped in the form of an arch having aplanar base forming the second end 28.

The second end 28 (base portion) has a length 30 (FIG. 1). A distance 32(FIG. 1) extends between the first end 26 and the second end 28 of thecase 20. The length 30 and the distance 32 are sized so that the biteportion 18 has an area which is sufficient to fit between at least someof the upper and the lower anterior teeth of a patient and sufficient sothat, when the patient bites down on the bite portion 18, at least someof the patient's upper and lower anterior teeth engage the case 20, butthe patient's upper and lower posterior teeth are spaced from the secondend 28 of the bite portion 18 and do not engage the bite portion 18, thepatient's posterior teeth being held in a spaced apart relationship.

The bite portion 18 has an upper surface 34 (FIGS. 1 and 2) and a lowersurface 36 (FIG. 2). The cavity fill pliable material 24 fills thecavity 22 of the case 20 and holds the upper surface 34 spaced adistance 38 (FIG. 2) from the lower surface 36.

The case 20 also is constructed of a pliable material of a type whichwill yield resulting in a partial collapsing of the case 20 as thepatient bites down on the case 20 and which will permit relativemovement between the upper and the lower anterior teeth during the useof the dental device 10. The construction of the case 20 of a pliablematerial and the cavity fill pliable material 24 cooperate to providethe portions of the centric bite assembly 16 constructed of pliablematerial which is selected to be yieldable when the patient bites downon the bite portion 18 and permit relative movement of the upper andlower teeth as the patient bites down on the bite portion 18. Thedistance 38 and the amount of cavity fill pliable material 24 disposedin the cavity 22 are determined to be sufficient so that, when thepatient bites down on the bite portion 18, the upper surface 34 of thebite portion 18 does not engage the lower surface 36 of the bite portion18, but rather remains spaced a distance from the lower surface 36.

The case 20 also is constructed of a material which, not only cooperateswith the cavity fill material 24 to permit the case 20 to partiallycollapse as the patient bites down on the bite portion 18, but also thecase 20 is constructed of a material which permits the upper and loweranterior teeth to move or slide relative to each other in directions 37and 39 (FIG. 1). More particularly, the occlusal surfaces of the loweranterior teeth slide in the direction 39 on the case 20 moving themandible toward centric relation with the maxilla as the patient bitesdown on the bite portion 18.

The pliable cavity fill material 24 cooperates with the pliable materialof the cast 20 so the sliding movement mentioned above is the result ofthe patient's natural muscle contraction and expansion on relaxation asthe patient bites down on the bite portion 18 and not caused by the biteportion 18 per se. The bite portion 18 does not result in a rampingeffect as the patient bites down on the bite portion 18 which wouldforce relative movement of the lower teeth in the direction 39 since thebite portion 18 conforms to the patient's upper and lower anterior teethas the patient bites down on the bite portion 18.

A tab 40 (FIGS. 1, 3 and 4) extends a distance from the first end 26 ofthe bite portion 18 and extends a distance angularly upwardly from theupper surface 34 of the case 20. The tab 40 is adapted to be gripped byan individual (dentist) for inserting and positioning the bite portion18 in a patient's mouth during the use of the dental device 10, as willbe described in greater detail below.

The dental device 10 also includes an impression support 42 (FIGS. 1 and3) having a first end 44 and a second end 46. The first end 44 isconnected to the second end 28 of the bite portion 18 so as to extendsubstantially longitudinally therefrom substantially as shown in FIGS. 1and 3. The impression support 42 extends a distance from the biteportion 18 terminating with the second end 46.

The impression support 42 has an upper impression support surface 48(FIGS. 1 and 3) and a lower impression support surface 50 (FIG. 3). Theupper and the lower impression support surfaces are spaced apart adistance 52 (FIG. 3). The upper and the lower impression supportsurfaces 48 and 50 preferably are planar and lie in parallel extendingplanes. A distance 54 (FIG. 1) extends between the first and the secondends 44 and 46 of the impression support 42.

As shown in FIGS. 1 and 3, a plurality of spaced apart openings 56 areformed through the impression support 42. Each of the openings 56extends through the impression support 42 intersecting the upper and thelower impression support surfaces 48 and 50. Only one of the openings 56is designated by a reference numeral in FIGS. 1 and 3 for clarity.

In one preferred embodiment, the dental device 10 is constructed of twosheets of 18 gauge polyurethane with one sheet disposed on top of theother and the two sheets are sealed together along the outer peripheraledges of the dental device 10, as indicated in FIG. 1 by the seal lines58. The cavity fill material 24 and the cavity 22 are sealing enclosedvia the case 20 along some of the seal lines 58. The two sheets aresealed together along the entire second end 28 of the bite portion 18for forming the cavity 22 there between so the case 20 sealinglyencloses the cavity 22.

In one embodiment, the cavity 22 was filled with a non-toxic gel of thetype identified commercially as propylene glycol, commercially availablefrom SAS Laboratories Incorporated, Newton, Mass. This embodiment of thedental device 10 had the following approximate dimensions: length 30 ofabout 5.8 cm; distance 32 of about 2.5 cm; distance 38 of about 0.8 cm;distance 52 of about 1.0 mm; distance 54 of about 3.8 cm.

The polyurethane sheets forming the bite portion 18 comprise the pliablematerial for the case 20 described above and the gel described abovecomprises the cavity fill pliable material 24. It should be noted thatthe case 20 may be constructed of any type of pliable material capableof performing the functions described herein and the cavity fill pliablematerial 24 may be any type of material such as the gel specificallyidentified above or a rubber or water or clay or cotton or any othertype of pliable material suitable for performing the functions of thecavity fill pliable material 24, as described herein.

Although the bite portion 18 is shown as being arch shaped, the biteportion 18 may be any geometric shape so long as the bite portion 18 isshaped to be positioned between at least some of the upper and the loweranterior teeth of a patient and provide biting surfaces for the upperand lower anterior teeth. For example, the bite portion 18 may berectangular shaped or somewhat triangular shaped.

The term "anterior teeth" generally refers to the cuspids and theintervening teeth therebetween. In one preferred embodiment, the biteportion 18 is shaped and sized to engage the anterior teeth from andincluding one cuspid to and including the other cuspid. It should benoted that the bite portion 18 could engage only the incisors and theintervening teeth or the bite portion 18 also could engage the lateralincisors and still perform the functions of the dental device 10 asdescribed herein. It only is sufficient that the bite portion 18 besized and shaped to engage at least some of the upper and lower anteriorteeth of the patient for holding at least most of the anterior teethspaced a distance apart while the patient bites downs on the biteportion 18 during the use of the dental device 10.

The dental device 10 is useful in at least three different applications.One recording centric relation, two relieving muscle trismus and painand three diagnosing temporal mandibular joint problems.

For recording centric relation, the dentist grips the tab 40 of thedental device 10 and, while holding the tab 40, the dentist inserts thedental device 10 into the patient's mouth between the upper and thelower teeth to a position wherein the bite portion 18 is disposedbetween at least some of the upper and the lower anterior teeth of thepatient, as generally shown in FIG. 5. The patient then bites down onthe bite portion 18 with at least some of the patient's upper anteriorteeth engaging the upper surface 34 of the case 20 and at least some ofthe patient's lower anterior teeth engaging the lower surface 36 of thecase 20, as generally shown in FIG. 6.

In this position, the patient bites down on the bite portion 18 ingeneral directions 60 and 62 (FIG. 2). As the patient's upper and loweranterior teeth engage the respective upper and lower surfaces 34 and 36of the case 20 and as the patient bites down on the case 20 in thedirections 60 and 62, the force of the patient's bite partiallycollapses the case 20 moving the upper and lower surfaces 34 and 36 ofthe case 20 generally in the directions 60 and 62 toward each other.Since the case 20 is constructed of a pliable material and since thecavity 22 is filled with the cavity fill pliable material 24, the case20 generally collapses somewhat moving the upper surface 34 toward thelower surface 36 as the patient bites down on the bite portion 18 of thedental device 10.

The cavity fill pliable material 24 and the case 20 are constructed sothat the cavity fill pliable material 24 always will support the uppersurface spaced a distance from the lower surface of the case 20 as thepatient bites down on the bite portion 18 and so the upper and the lowerposterior teeth of the patient are spaced a distance apart when thepatient has bitten down with full force on the bite portion 18 with afull power bite.

The term "power bite" as used herein means that the patient has bittendown on the bite portion 18 while at least some of the posterior teethare held a distance apart by the bite portion 18 positioned between atleast some of the anterior teeth. In this position, the muscles locatedbehind the teeth then can contract, forcing the jaw into the centricrelation position because there substantially are no posterior teethtouching or interfering with this movement.

The patient retains this power bite position for a period of time suchas 5 or 20 minutes for example allowing or permitting the elevatormuscles to center the condyle in centric relation while the positionermuscles relax thereby moving the mandible and the maxilla into centricrelation.

After the mandible and the maxilla are positioned in centric relation,the patient opens the patient's mouth and the dentist removes the dentaldevice from the patient's mouth. At this stage, it is important that thepatient's mouth remains open leaving the mandible and the maxilla incentric relation. In other words, it is important at this stage that thepatient not bite down and move the mandible and the maxilla out ofcentric relation. Preferably, the dentist will place a cotton rollbetween the anterior teeth of the patient to prevent the patient fromclosing the patient's mouth at this stage.

While the patient's mouth is maintained open or, in other words, whilethe patient's upper and lower teeth are maintained in a spaced apartrelationship, the dentist then attaches the upper impression material 12(FIGS. 3 and 4) to the upper impression support surface 48 of theimpression support 42 and attaches a lower impression 14 (FIGS. 3 and 4)to the lower impression support surface 50 of the impression support 42.

The upper and lower impression materials 12 and 14 are shown in FIG. 4connected to the impression support 42 in FIG. 4. One preferred way ofattaching the upper and the lower impression material 12 and 14 to theimpression support 42 is to use an impression material of the type whichis relative hard at room temperatures and pliable or relatively soft atelevated temperatures. One such impression material is of the typegenerally referred to as BITE-REGISTRATION WAX and commerciallyavailable from DeLar Corporation, Lake Oswego, Oreg. In one embodimentwhen using impression materials of this type, each impression material12 and 14 had a thickness of about 2.5 mm giving an overall thickness ofthe two impression materials 12 and 14 of about 5 mm.

Using an impression material of the type described above for the upperand the lower impression materials 12 and 14, the dentist places theupper and the lower impression materials 12 and 14 in warm water orotherwise raises the temperature of the impression materials 12 and 14so they soften. In this softened condition, the dentist places the upperimpression material 12 on the upper impression support surface 48 andplaces a lower impression material 14 on the lower impression supportsurface 50 forcing the upper and the lower impression materials 12 and14 toward each other and against the respective upper and the lowerimpression support surfaces 48 and 50.

While in this softened condition of the impression materials 12 and 14,the impression materials 12 and 14 tend to bind to the respective upperand lower impression support surface 48 and 50 thereby connecting theupper and lower impression materials 12 and 14 to the impression support42 of the dental device 10. The openings 56 permit some of theimpression materials 12 and 14 to flow into the openings 56 as the upperand the lower impression materials 12 and 14 are pressed against theimpression support 42 thereby providing a more secure connection betweenthe impression support 42 and the upper and lower impression materials12 and 14.

The upper and lower impression materials 12 and 14 are sized and shapedand positioned on the dental device 10 to be positioned between theupper and lower posterior teeth of the patient when the dental device 10is reinserted into the patient's mouth. As shown in FIGS. 3 and 4, theupper and the lower impression materials 12 and 14 are positioned nearthe second end 28 of the bite portion 18 and each of the impressionmaterials 12 and 14 extends a distance from the bite portion 18 and mayextend a distance form the second end 46 of the impression support 42with the impression support 42 being disposed between the upper and thelower impression materials 12 and 14 and cooperating to provide theconnection between the upper and the lower impression materials 12 and14 and the bite portion 18. The impression support 42 has a thickness,that is, the distance 52 extending between the upper impression supportsurface 48 and the lower impression support surface 50. This distance 52is determined along with the thickness of the impression materials 12and 14 to be of a sufficient size so that, when the patient bites downon the bite portion 18, the patient's upper and lower posterior teethwill engage and make a sufficient impression in the impression materials12 and 14.

When the softened impression materials 12 and 14 are placed adjacent theimpression support 42 and pressed into position on the impressionsupport 42, the impression support 42 impresses an impression of theimpression support 42 in the impression materials 12 and 14. Thus, in aconnected position, the impression materials 12 and 14 are disposedabout adjacent each other and the upper impression material 12 isconnected to the lower impression material 14.

The impression materials 12 and 14 have an overall thickness 74 (FIG. 4)which is about the same as the distance 38 (FIG. 2) between the upperand the lower surfaces of the bite portion 18. In any event, theimpression materials 12 and 14 are sized and selected so that, whenpositioned on the impression support 42 and when the dental device 10 isinserted into the patient's mouth, the patient's upper and lowerposterior teeth will engage and make impressions on the impressionmaterials 12 and 14 as the patient bites down on the bite portion 18 inthe manner described herein.

After the upper and the lower impression materials 12 and 14 have beenconnected to the impression support 42 and while the upper and the lowerimpression materials 12 and 14 still are in the softened condition, thedentist removes the roll of cotton from the patient's mouth and whilemaintaining the upper and the lower teeth spaced a distance apart, thedentist reinserts the dental device 10 into the patient's mouth andpositions the bite portion 18 between at least some of the upper andlower anterior teeth thereby positioning the upper and the lowerimpression materials 12 and 14 generally between some of the patient'supper and lower posterior teeth. In this position of the dental device10, the patient bites down on the dental device 10, as shown in FIG. 7.As the patient bites down on the dental device 10, at least some of thepatient's upper and lower anterior teeth engage the bite portion 18 inthe manner described before and at least some (preferably all) of thepatient's upper and lower posterior teeth engage the respective upperand the lower impression materials 12 and 14. As the patient bites downon the dental device 10, the dentist may hold the patient's jaw tomaintain centric relation if the patient tends to move the jaw forwardout of centric relation.

As the patient's occulsal surfaces of the upper and lower posteriorteeth engage the respective upper and the lower impression material 12and 14, the engagement results in an impression of portions of the upperand the lower posterior teeth of the patient being made in therespective impression materials 12 and 14. During this stage, thepatient should bite down on the bite portion 18 and the impressionmaterials 12 and 14 as hard as practically possible to make clearimpressions and impressions which are of a sufficient depth.

After the impressions have been made in the impression materials 12 and14, the impression materials 12 and 14 then are cooled (hardened) by thedentist using cool water sprayed on the impression materials 12 and 14for example while the dental device 10 including the impressionmaterials 12 and 14 still are in the patient's mouth. After theimpression materials 12 and 14 have been hardened, the dental device 10including the impression materials 12 and 14 connected thereto areremoved from the patient's mouth. The impression materials 12 and 14then contain an impression of the patient's upper and lower anteriorteeth with the patient's mandible and maxilla in centric relation.

The dental device 10 including the impressions of the upper and lowerposterior teeth in the impression materials 12 and 14 then is used toposition a maxillary stone model 80 (FIG. 8) and a mandibular cast 82(FIG. 8) in proper relationship on an articulator 84 (FIGS. 6, 7 and 8)for use by the dentist in various reconstructive procedures.

First, the dentist, using any sharp instrument (not shown), makes a cutin the case 20 providing access to the cavity 22. At least a substantialportion of the cavity fill material 24 then is removed from the cavity20. This will permit occlusal surfaces of the anterior teeth on themaxillary stone model 80 and the mandibular cast 82 to somewhat engagewith only the materials forming the case 20 being disposed therebetween,as illustrated in FIG. 8.

Articulators and their use with maxillary stone models and mandibularcasts are well known in the art of dentistry and a detailed descriptionof the construction and use of such is not deemed necessary. In FIG. 8,the articulator 84 is shown only as typical representation of anyarticulator and is not intended to represent any particular articulator.

At this stage, the dentist already has made the maxillary stone model 80and the mandibular cast 82 for the particular patient. The maxillarystone model 80 initially is mounted with a facebow on the articulator84.

The articulator 84 then is turned upside down to the position shown inFIG. 8 with the maxillary stone model 80 under the mandibular cast 82.The dental device 10 is positioned on the maxillary stone model 80 withthe impressions of the upper posterior teeth in the upper impressionmaterial 12 positioned in the occlusal surfaces of the upper posteriorteeth of the maxillary stone model 80. The occlusal surfaces of themandibular cast 82 then are positioned in the impressions of the lowerposterior teeth in the lower impression material 14 thereby positioningthe mandibular cast 82 and the maxillary stone model 80 in a truecentric relation, in the position shown in FIG. 8.

The mandibular cast 82 then is secured or mounted (not shown) to thearticulator 84 in this position. The mandibular cast 82 and themaxillary stone model 80 are now positioned on the articulator 84 in atrue centric relation determined by the contracted elevator muscles, therelaxed positioner muscles and the condyle placed in the apex of forceall determined by the particular patient.

As mentioned before, the dental device 10 also can be used to relievemuscle trismus and pain. The impression support 42 and the impressionmaterials 12 and 14 are not necessary for the procedure, although theimpression support 42 may be included on the dental device 10, ifdesired. For this procedure, the dental device 10 is positioned in thepatient's mouth in a position wherein the bite portion 18 is positionedbetween at least some of the patient's anterior upper and lower teeth inthe same manner as described before. The patient then bites down on thebite portion 18 with the anterior teeth engaging the bite portion 18 andproviding forces in directions 60 and 62 on the bite portion 18partially collapsing the upper and lower surfaces 34 and 36 in thedirections 60 and 62 generally toward each other, in the same manner asdescribed before. As the patient bites down on the bite portion 18 andas this position is maintained for a period of time, the mandible andthe maxilla are moved into centric relation in the manner describedbefore with the elevator muscles contracting and the positioner musclesrelaxing. In this position, pain caused by the muscles, subsides.

Also, as mentioned before, the dental device 10 is useful in diagnosingtemporal mandibular joint problems. The impression support 42 and theimpression materials 12 and 14 are not necessary for the procedure,although the impression support 42 may be included on the dental device10 if desired. With this procedure, the dental device 10 is positionedin the patient's mouth in the manner described before with the biteportion 18 generally positioned between at least some of the patient'supper and lower anterior teeth. In this position, the patient bites downon the bite portion 18 as hard as possible. While the patient bites downon the bite portion 18, if the disk has been displaced forward, the headof the condyle will be compressing the distal ligament, nerve endingsand blood vessels against the eminences causing pain. Thus, the dentistcan determine that it is a displaced disk causing the problem and it isnot a muscle problem. On the other hand, if the disk is between the headof the condyle and eminence and the biting down causes no pain, thedentist knows it is a muscle problem.

As described herein, the dental device 10 is used to relax the musclesso that the condyle will set in the centric relation position. Thedental device 10 allows the mandible to adjust to the position ofcentric relation as the muscles relax. The dental device 10 does nothave a ramp effect that would cause the mandible to distalize or, inother words, to go too far back, posteriorly. The dental device 10 doesnot require customized appliances to be made for each patient. Thedental device 10 is quick and simple and one bite fits all patients. Thedental device 10 is a one piece device when the upper and the lowerimpression materials 12 and 14 are connected to the bite portion 18 anddoes not come in two pieces when being used by the dentist.

As described herein, the bite portion 18 comprised the case 20 withcavity fill material 24 disposed in the cavity 22. Rather than thedentist cutting the case 20 and forcing some of the cavity fill material24 out of the case 20 during some of the operations as described herein,the dentist could simply cut the bite portion 18 from the impressionsupport 42, thereby leaving the impression support 42 with theimpression materials 12 and 14 connected thereto for use with thearticulator 84 in the manner described before. Also, it should be notedthat the bite portion 18 could be one solid piece constructed of apliable material, rather than a case with a cavity fill with cavity fillmaterial. In this last mentioned embodiment, the bite portion would becut and removed from the impression support 42 with the impressionmaterials 12 and 14 connected thereto for use with the articulator 84 inthe manners described before.

Changes may be made in the construction and the operation of the variouscomponents, elements and assemblies described herein and changes may bemade in the steps or the sequence of steps of the methods describedherein without departing from the spirit and scope of the invention asdefined in the following claims.

What is claimed:
 1. A dental device sized and shaped so as to beinserted into a patient's mouth to position the mandible and the maxillain centric relation, comprising:a centric bite assembly positionablewithin the patient's mouth, the centric bite assembly comprising apliable bite portion having a first end, a second end, an upper surfaceand a lower surface defining a cavity, and a pliable material disposedwithin the cavity so that when the patient bites down on the pliablebite portion the upper and lower surfaces of the centric bite portionare maintained a distance apart while permitting the upper and loweranterior teeth to move relative to each other while maintaining thepatient's upper and lower posterior teeth spaced a distance apart; andan impression support assembly having a first end, a second end, anupper impression support surface and lower impression support surface,the first end on the impression support assembly connected to the secondend of the pliable bite portion of the centric bite assembly such thatthe impression support assembly extends longitudinally from the secondend of the pliable bite portion of the centric bite assembly.
 2. Thedental device of claim 1, wherein the first end of the pliable biteportion of the centric bite assembly is provided with a substantiallyarch configuration with the second end of the pliable bite portion ofthe centric bite assembly forming a substantially planar base of thearch.
 3. The dental device of claim 1, further comprising:impressionmaking means connected to at least one of the upper impression supportsurface and lower impression support surface of the impression supportassembly for making impressions of at least a portion of the patient'supper and lower posterior teeth when the patient bites down on theimpression means.
 4. The dental device of claim 3, wherein theimpression support assembly is further defined as having at least oneopening formed therethrough to enhance connection of the impressionmaking means to at least one of the upper and lower impression supportsurfaces of the impression support assembly.
 5. The dental device ofclaim 3, wherein the impression making means comprises:a pliablematerial.
 6. The dental device of claim 5, wherein the pliable materialis disposed on and connected to the upper impression support surface andlower impression support surface of the impression support assembly. 7.The dental device of claim 1, further comprising:a tab connected to andextending from the first end of the pliable bite portion of the centricbite assembly, the tab being sized and shaped to permit gripping by anindividual so as to assist the individual in holding the and insertingthe pliable bite portion into the patient's mouth between at least aportion of the patient's upper and lower anterior teeth.
 8. A method formaking impressions of at least a portion of a patient's upper and lowerposterior teeth with the patient's mandible and maxilla positioned in acentric relation using a dental device sized and shaped so as to beinserted into a patient's mouth, comprising the steps of:providing thedental device, wherein the dental device comprises:a centric biteassembly comprising a pliable bite portion having a first end and asecond end, and an impression support assembly having a first end and asecond end, the first end on the impression support assembly connectedto the second end of the pliable bite portion of the centric biteassembly such that the impression support assembly extendslongitudinally from the second end of the pliable bite portion of thecentric bite assembly; positioning the centric bite assembly in thepatient's mouth between at least a portion of the patient's upper andlower anterior teeth; biting, by the patient, on the centric biteassembly with at least a portion of the patient's upper and loweranterior teeth bitingly contacting the pliable bite portion of thecentric bite assembly to partially collapse the pliable bite portion ofthe centric bite assembly, the partially collapsed pliable bite portionof the centric bite assembly maintaining the patient's upper and lowerposterior teeth spaced a distance apart as the patient bites down on thecentric bite assembly, the pliable bite portion of the centric biteassembly partially collapsing and permitting the lower anterior teeth tomove relative to the upper anterior teeth, without causing asubstantially ramping effect, thereby positioning the mandibular andmaxilla in centric relation; maintaining the patient biting down on thecentric bite assembly for a period of time sufficient for the mandibleand maxilla to move into centric relation; removing the dental devicefrom the patient's mouth; maintaining the patient's mouth in an openedposition; connecting impression making means to the impression supportassembly; inserting the dental device with the impression making meansconnected to the impression support assembly into the patient's mouth,wherein the pliable bite portion of the centric bite assembly ispositioned between at least some of the patient's upper and loweranterior teeth and the impression support assembly having the impressionmaking means connected thereto is positioned between at least some ofthe patient's upper and lower posterior teeth; biting, by the patient,on the centric bite assembly with at least some of the patient's upperand lower anterior teeth bitingly contacting the pliable centric biteportion of the centric bite assembly and with at least some of thepatient's upper and lower posterior teeth bitingly contacting theimpression making means on the impression support assembly; and removingthe dental device with the impression making means connected theretofrom the patient's mouth, wherein the dental device provides impressionsof at least a portion of the patient's upper and lower posterior teethin the impression making means, thereby indicating the position of thepatient's upper and lower posterior teeth when the patient's mandibleand maxilla are positioned in centric relation.
 9. The method of claim8, wherein in the step of providing the centric bite assembly, thecentric bite assembly further comprises a case having a cavity formedtherein filled with a pliable cavity fill material.
 10. The method ofclaim 9, further comprising the steps of:providing an articulator havinga maxillary stone model of the patient's lower teeth mounted thereon andproviding a mandibular cast of the patient's teeth; removing the pliablecavity fill material from the cavity of the case of the centric biteassembly; placing the impression of the patient's upper posterior teethformed in the impression making means on occlusal surfaces of the upperposterior teeth of the maxillary stone model; placing occlusal surfacesof the mandibular cast on the opposite side of the impression makingmeans having the impressions of the patient's upper posterior teethformed therein thereby positioning the mandibular cast in a centricrelation with respect to the maxillary stone model; and connecting themandibular cast to the articulator.
 11. The method of claim 8, furthercomprising the steps of:providing an articulator having a maxillarystone model of the patient's lower teeth mounted thereon; removing theimpression making means from the impression support assembly; placingthe impression making means on the maxillary stone model such that theimpression of the patient's upper posterior teeth formed in theimpression making means overlay occlusal surfaces of the upper posteriorteeth of the maxillary stone model; placing occlusal surfaces of themandibular cast on the opposite side of the impression making means,thereby positioning the mandibular cast in a centric relation withrespect to the maxillary stone model; and connecting the mandibular castto the articulator.
 12. A method for relieving muscle trismus and paincaused by muscles using a dental device sized and shaped so as to beinserted into a patient's mouth, comprising the steps of:providing thedental device, wherein the dental device comprises:a partiallycollapsible centric bite assembly constructed of pliable material, thecentric bite assembly having a first end and a second end, the centricbite assembly sized and shaped so as to be positionable in the patient'smouth generally between at least a portion of the patient's upper andlower anterior teeth; and an impression support assembly having a firstend and a second end, the first end of the impression support assemblyconnected to the second end of the centric bite assembly such that theimpression support assembly extends substantially longitudinally fromthe second end of the centric bite assembly; positioning the centricbite assembly in the patient's mouth between at least a portion of thepatient's upper and lower anterior teeth; biting, by the patient, on thecentric bite assembly with at least a portion of the patient's upper andlower anterior teeth bitingly contacting the centric bite assembly,wherein the centric bite assembly maintains the patient's upper andlower posterior teeth spaced a distance apart as the pliable centricbite assembly partially collapses thereby permitting the lower anteriorteeth to move relative to the upper anterior teeth, without causing asubstantially ramping effect, for cooperating in positioning themandibular and maxilla in centric relation as the patient bites down onthe centric bite assembly.
 13. A method for diagnosing temporalmandibular joint problems in a patient using a dental device sized andshaped so as to be inserted in a patient's mouth for positioning themandible and the maxilla in a centric relation, comprising the stepsof:providing the dental device, wherein the dental device comprises:apliable, partially collapsible centric bite assembly constructed of apliable material, the centric bite assembly having a first end, a secondend and sized and shaped to be positionable in the patient's mouth so asto be disposed between at least a portion of the patient's upper andlower anterior teeth engage the centric bite assembly; and an impressionsupport assembly connected to the second end of the centric biteassembly such that the impression support assembly extends substantiallylongitudinally from the second end of the centric bite assembly;positioning the centric bite assembly in the patient's mouth between atleast a portion of the patient's upper and lower anterior teeth; biting,by the patient, on the centric bite assembly with at least a portion ofthe patient's upper and lower anterior teeth bitingly contacting thecentric bite assembly, wherein the centric bite assembly maintains thepatient's upper and lower posterior teeth spaced a distance apart as thepliable centric bite assembly partially collapses thereby permitting thelower anterior teeth to move relative to the upper anterior teeth,without causing a substantially ramping effect, for cooperating inpositioning the mandibular and maxilla in centric relation as thepatient bites down on the centric bite assembly, wherein the disk of thetemporal mandibular joint is displaced forward, the head of the condylewill compress the distal ligament, nerve endings and blood vesselsagainst the eminences thereby causing pain indicating a displaced diskas the diagnosed problem, and where the disk of the temporal mandibularjoint is between the head of the condyle and eminences and causes nopain, indicating a muscle problem.